Provider Demographics
NPI:1467525147
Name:FITZPATRICK, JOSEPH MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:FITZPATRICK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 GREAT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-4187
Mailing Address - Country:US
Mailing Address - Phone:978-263-5592
Mailing Address - Fax:978-635-9125
Practice Address - Street 1:468 GREAT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-4187
Practice Address - Country:US
Practice Address - Phone:978-263-5592
Practice Address - Fax:978-635-9125
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1419111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
759438OtherTUFTS HEALTH PLAN
MA350085OtherHARVARD PILGRIM HEALTH CA
4268481OtherAETNA
MAY45971OtherBLUE CROSS BLUE SHIELD
4404375OtherUNITED HEALTHCARE
4404375OtherUNITED HEALTHCARE
MAU64417Medicare UPIN